Cerebrospinal Fluid Fistula Csf Leak

Overview, Causes, & Risk Factors

Cerebrospinal fluid, also known as CSF, leak is an abnormal drainageof cerebrospinal fluid from the subarachnoid space in the brain.The fluid may leak out into the body, but more often it is seen leakingthrough the ears, nose, or an open wound.

What is going on in the body?

CSF is formed within the inner spaces of the brain calledventricles. The fluid travels through the ventricles and exits thebrain beneath the cerebellum, which is at the base of the head. It then travelsdown the spine, around the spinal cord and nerves, and back up to thehead. The final step is passing over the top of the brain where it is absorbed.The fluid is held between the arachnoid and dura membranes. Thesemembranes enclose the brain and spinal cord. Leakageoccurs when the arachnoid membrane is ruptured.

What are the causes and risks of the condition?

A CSF leak is caused by a rupture of the arachnoid membrane.This usually results from trauma, although it can occur spontaneously.Tissue destruction caused by tumors could lead to a CSF leak.

Symptoms & Signs

What are the signs and symptoms of the condition?

CSF is a clear, watery liquid that leaks out of the nose, ear,or a wound. Headacheis common with a CSF leak. It may be relieved when the person sits upright from a lyingposition. However, changing to this position may cause the flow of fluid toincrease. Coughing or sneezing can also cause an increased flow of CSF.

Diagnosis & Tests

How is the condition diagnosed?

Diagnosis is made through observation and by testing anysuspicious watery fluidfor glucose, which is present in cerebrospinal fluid. X-ray studies maybe needed to find the exact place where the membrane has ruptured.Other studies may include CT scans.

Prevention & Expectations

What can be done to prevent the condition?

There is no way to prevent a CSF leak except by avoidingtrauma. Sports safety guidelines for children,adolescents,and adultscan help avoid head injury during sports.

What are the long-term effects of the condition?

Chronic leakage may occur at times. The leak most commonlycomes from the nose. A long-term result may result in the loss of the senseof smell.

What are the risks to others?

There are no risks to others.

Treatment & Monitoring

What are the treatments for the condition?

Leakage through the nose or ears following traumausually gets better with rest. Antibiotics are given if an infection ispresent. If the leakage persists, the doctor may place catheters inthe lumbar spine to reroute the CSF. Surgical closure ofthe ruptured membrane is rarely needed. If leakage is caused by erosiondue to tumor or infection, the underlying cause must be treated.

What are the side effects of the treatments?

Infection of the trauma site and failure of the rupture toclose spontaneously may sometimes occur. In cases of a skullfracture, swelling may damage a cranial nerve, leading to weaknessor paralysis on the side of the face. These injuries commonly result inhearing loss on the affected side.

What happens after treatment for the condition?

Treatment is usually successful, although complicationssuch as infection can occur.

How is the condition monitored?

A person should be monitored for infection and recurrenceof CSF leakage. A change of therapy may be needed if infection orrecurrence takes place. Any new or worsening symptoms should bereported to the doctor.

Article type: xmedgeneral

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